Falls are associated with substantial harm to the elderly, as well as high societal costs. The overall goal of the Phase I SBIR application is to deploy and validate a vibration and motion sensor-based monitoring system that both a) reliably detects falls and b) provides the data necessary to develop a model to predict and, thus prevent, falls in older adults. We have a fully developed prototype of an entirely passive fall detection system (FDS) that is ready for deployment. The specific aims for this Phase I application are as follows: 1) Develop algorithms to model the three most common types of falls by analyzing retrospectively collected data from the FDS datasets;2): Validate algorithms by collecting and analyzing prospective (real time) FDS data and comparing with the incident nurse reports (current gold standard);3) Identify gait signatures that proceeded recorded fall;and 4) Obtain resident/family members/staff perspectives on the FDS. The proposed SBIR Phase I application is particularly timely, given the Health Care Reform Bill that contains several provisions relevant to aging-services technologies, including the use of aging services technologies and new models of funding for long- term care services and supports. While commercially available remote monitoring systems are currently in use, none have been evaluated in non-company sponsored prospective randomized trials. The proposed Phase I application will provide the technical foundation to support a Phase II randomized trial to evaluate the cost- effectiveness of the proposed FDS. These data are needed to move this technology from a "promising" to an "evidence-based" practice, to justify coverage by the Center for Medicare and Medicaid Services (CMS) and commercial payers. Currently, remote health management represents 1.4 percent of the market for home health monitoring in the U.S., but is expected to double from $1.8 billion in 2007 to $3.6 billion in 2012. This Phase I application is a collaboration among Environment and Health Group, Inc. and our partners at the University of South Carolina, Palmetto Health (PH), and the South Carolina Regional Authority, which is legislatively mandated to focus on the commercialization of new knowledge-based discoveries that derive from the University, and whose program SCLaunch, provides matching funds for awarded SBIR grants. PUBLIC HEALTH RELEVANCE: This project will result in a fall detection system (FDS) based on 2 passive sensors (floor vibration and motion) and their accompanying data handling systems. The proposed product has substantial benefits over existing fall detection systems, as it does not require the person to wear or activate an alarm for assistance, is entirely hidden from view, and poses no threats to privacy. Given the anticipated shortages in the number of health care workers available to care for an increasingly number of frail older adults, such a monitoring system has enormous potential for uptake by nursing homes, assisted living facilities, and other environments where older adults reside.